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The coastal lagoons of the Gulf of California support important traditional fisheries and mollusc cultures (generally oysters) and receive important volumes of agricultural, industrial and urban effluents, consumption of the oysters could pose risk to human health. The concentrations of arsenic (As), cadmium (Cd), copper (Cu), iron (Fe), lead (Pb), and zinc (Zn) in the oysters Saccostrea palmula and Crassostrea corteziensis, from four coastal lagoons (Altata, AL; Macapule, ML; Navachiste, NL; El Colorado, ECL) in the Southeast Gulf of California, were seasonally evaluated (summer 2019-spring 2020). The order of magnitude of potentially toxic elements concentrations in the soft tissue in both oyster species and at all sites was Zn > Fe > Cu > As > Cd > Pb. Cadmium, Cu, Pb, and Zn exceeded the maximum permissible limits in more than one sampling site. The highest concentrations (mg kg-1, wet weight) of As (4.2 ± 1.1, spring) and Cd (3.3 ± 0.7, autumn) were registered in S. palmula et al. and NL sampling sites, respectively. Crassostrea corteziensis presented higher levels of Cu (40.5 ± 6.7, spring), Pb (2.0 ± 0.4, spring), and Zn (96.9 ± 20.4, spring) in ECL and Fe (62.2 ± 25.4, autumn) in ML. The hazard quotient (HQ) values exceeded the safe level of 1 for Cd in S. palmula and C. corteziensis in NL for children (~ 16 kg weight). In addition, in children, the hazard index (HI) values in both species of oysters ranged from 0.7 to 2.1 and 0.6 to 1.9, respectively. On the other hand, the intake of the studied elements through the consumption of oysters would not induce adverse effects to human health (men and women weighing 70 and 60 kg, respectively); HQ and HI values were < 1.

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Introducción: La malaria continúa siendo un importante problema de salud a nivel mundial, su diagnóstico temprano y tratamiento inmediato son fundamentales para prevenir las complicaciones y la muerte. Objetivo: Reportar el caso de un paciente cubano procedente de República de Guinea, que presentó malaria complicada por Plasmodium falciparum, el cual fue hospitalizado en el Instituto de Medicina Tropical Pedro Kourí (IPK). Caso clínico: Paciente masculino, cubano, de piel negra, 63 años de edad, profesión marinero mercante. Sin antecedentes patológicos personales. Llegó al IPK en camilla, con cierto deterioro de la conciencia, debilidad generalizada, dificultad respiratoria y compromiso del ritmo diurético. Ingresó en la Unidad de Cuidados Intensivos donde recibió tratamiento con los antipalúdicos artesunato y primaquina. La parasitemia fue descendiendo en el decursar de los días. El paciente sobrevivió y egresó satisfactoriamente a los 16 días posteriores a su ingreso. Fue debidamente notificado a las autoridades del Ministerio de Salud Pública de Cuba, lo que constituye un procedimiento obligatorio del Sistema Nacional de Vigilancia de Enfermedades Transmisibles en Cuba. Conclusión: La rapidez en el diagnóstico, así como el tratamiento integral, eficaz y oportuno, fue de importancia vital y condujo a un buen desenlace de la enfermedad.

Introduction: Malaria continues to be a major health problem worldwide, its early diagnosis and prompt treatment are critical to prevent complications and death. Objective: To report the case of a Cuban patient from the Republic of Guinea, who presented with complicated Plasmodium falciparum malaria, who was hospitalized at the Institute of Tropical Medicine Pedro Kourí (IPK). Clinical case: Male patient, Cuban, black-skinned, 63 years old, occupation: merchant seaman. No personal pathological history. He arrived at the IPK on a stretcher, with some deterioration of consciousness, generalized weakness, respiratory distress and diuretic rhythm compromise. He was admitted to the Intensive Care Unit where he received treatment with the antimalarial drugs artesunate and primaquine. Parasitemia decreased over the days. The patient survived and was discharged satisfactorily 16 days after admission. This case was duly notified to the authorities of the Ministry of Public Health of Cuba, which is a mandatory procedure of the National Surveillance System of Communicable Diseases in Cuba. Conclusion: Prompt diagnosis, as well as a comprehensive, effective, and timely treatment was vital and led to a good disease outcome.

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RESUMEN INTRODUCCIÓN: La leucodistrofia metacromática (LDM) es una enfermedad poco frecuente que se caracteriza por desmielinización progresiva a nivel del sistema nervioso central y periférico. En la mayoría de los casos, es causada por una actividad deficiente de la enzima arilsulfatasa-A. Pertenece al grupo de las leucodistrofias, que son trastornos hereditarios de la sustancia blanca asociados con una variabilidad fenotípica y una heterogeneidad genética importante. El fenotipo de la LDM suele relacionarse con la edad de presentación, que puede variar desde la infancia hasta la adultez. Cuando se presenta en la edad adulta, puede debutar con manifestaciones neuropsiquiátricas, lo que lleva con frecuencia a diagnósticos erróneos. REPORTE DE CASO: Se presenta el caso de una paciente adulta que debutó con un cuadro clínico caracterizado por cambios comportamentales progresivos, con posterior inicio de manifestaciones clínicas motoras. El diagnóstico de LDM se sospechó a partir de la clínica y los hallazgos típicos en la resonancia magnética (RM) cerebral, y se confirmó con la detección de actividad deficiente de la arilsulfatasa-A (ARSA) y la secuenciación del gen ARSA que confirmó la mutación en estado homocigoto, compatible con este diagnóstico. DISCUSIÓN: Destacamos en este caso la importancia de la sospecha clínica, el reconocimiento temprano y el manejo multidisciplinario como factores pronósticos del curso de la enfermedad, ya que en la actualidad no hay tratamiento definitivo para la enfermedad.

ABSTRACT INTRODUCTION: Metachromatic leukodystrophy (MLD) is an infrequent disease characterized by progressive demyelination of the central and peripheral nervous system. In most cases, it is caused by deficient activity of arylsulfatase-A. It belongs to the group of leukodystrophies, which are inherited white matter disorders that can be associated with significant phenotypic variability and genetic heterogeneity. The phenotype in MLD is usually related to the age of onset, which can vary from childhood to adulthood. Adult-onset MLD can debut with neuropsychiatry symptoms, which can often lead to misdiagnosis. CASE REPORT: We report the case of an adult female patient who presented with progressive behavioral changes, followed by motor manifestations. MLD was initially suspected based on the clinical presentation and the characteristic findings on brain magnetic resonance imaging (MRI), with subsequent confirmation by detection of deficient arylsulfatase-A (ARSA) activity and ARSA gene sequencing, which demonstrated homozygosity, compatible with this diagnosis. DISCUSSION: We highlight the importance of clinical suspicion, early recognition and multidisciplinary management as a prognostic factor for the course of the disease, since there is currently no definitive treatment for the disease.

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Abstract The present work aims to study which factors are relevant in long-term mate selection from a lonely-hearts personal advertisement sample of Spanish-speaking consumers of Cosmopolitan Magazine, Colombian Edition. We analyzed One thousand four hundred sixty-eight publications (made by 770 men and 698 women) using a coding system based on the theories of sexual strategies, genetic quality indicators, and the preferences classification used in personal ads studies. Initially, we found trends as a greater predilection for psychological attributes and a greater demand to require more traits than offering them. In addition, the cross-cultural pattern demonstrated that men prefer women's physical characteristics, while women require status/resources by men. Finally, men tended to be more selective in the age range of 36-45 years, while women's selectivity decreased with age. The results replicate many of the patterns found in investigations related to human sexual selection, also bring enlightenment about new preference dimensions to study in the future.

Resumen La presente investigación examina las preferencias de individuos que buscan emparejarse a largo plazo, por medio del análisis de anuncios de búsqueda de parejas, publicados por una muestra de usuarios hispanohablantes de la edición Colombiana de la Revista Cosmopolitan. Se revisaron 1468 publicaciones (de 770 hombres y 698 mujeres) utilizando un sistema de codificación construido a partir de la teoria de estrategias sexuales, indicadores de calidad genética y clasificaciones usadas en estudios de anuncios personales. Los usuarios reportaron una mayor atención por atributos psicológicos, además de una alta exigencia. Adicionalmente, los hombres solicitaron más características fisicas de las mujeres, y las mujeres más indicadores asociados al estatus y recursos de los hombres. Los hombres se mostraron más selectivos entre los 36 y los 45 anos, mientras que la selectividad de las mujeres disminuyó con la edad. Los resultados replican patrones encontrados en las investigaciones sobre emparejamiento sexual humano, y dan luces sobre nuevos dominios de preferencia para examinar en el futuro.

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Non-alcoholic fatty liver disease (NAFLD) has a high prevalence and risk of progression to cirrhosis and other complications in patients with type 2 diabetes mellitus (T2DM). Likewise, the presence of NAFLD implies a high risk of developing T2DM, determining a bidirectional relationship between them. The diabetology and hepatology societies, developed a joint initiative aiming to unify criteria, reviewing the definitions, diagnostic criteria, risk stratification, treatment, and follow-up of patients with NAFLD and T2DM. The key questions to be discussed were defined by a panel of specialists in diabetology and hepatology. The Delphi methodology was used to reach consensus on the respective recommendations. Based on the discussion generated among the experts, diagnostic and treatment algorithms were proposed, as well as an indication for referral and the role of the different specialists involved in the management of these patients. Strengthening multidisciplinary work with patients with NAFLD and T2DM will allow the early recognition of the disease, the prevention of the progression to cirrhosis, and reducing the associated complications.

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This study describes the incidence of early events supposedly attributable to vaccination or immunization (ESAVI) that occurred in healthcare workers who had been inoculated with the first component of the Sputnik V vaccine. Safety at 72 h post-immunization was analyzed based on a self-reported form. Between January 5 and January 20, 2021, in Buenos Aires, Argentina, a total of 707 healthcare workers (median age 35 yrs, female 67%) were vaccinated. The response rate was 96.6% (n: 683) and 487 (71.3%) participants reported at least one ESAVI. The incidence rate was 6.3 per 1000 person/hours. The total number of ESAVIs was 1434. A total of 469 local reactions were reported, 57% of the participants reported pain at the injection site, and 11% had redness and swelling. A total of 968 systemic reactions were informed, including new or worsened muscle pain, referred by 58% of the participants, fever referred by 40%, and diarrhea referred by 5%. Five percent (n: 34) had serious adverse events and one participant had to be hospitalized. The ESAVI rate was higher in females than males (66.4% versus 51.4%; HR 1.38; 95% CI 1.13-5.38) and in workers younger than 55 yrs old (63.0% versus 28.0%; HR 2.66; 95% CI 1.32-5.38). This study demonstrates high rates of early local and systemic reactions. However, serious events were rare. Studies on long-term safety, stratified by sex and age, are needed.

Este estudio describe la incidencia de eventos supuestamente atribuibles a vacunación o inmunización (ESAVI) en trabajadores de la salud después de la inmunización con el primer componente de la vacuna Sputnik V. La seguridad a las 72 horas de la inmunización se analizó en base a un auto-reporte. Entre el 5 y el 20 de enero de 2021, en Buenos Aires, Argentina, fueron vacunados 707 trabajadores de la salud (mediana de edad 35 años, 67% mujeres). La tasa de respuesta fue 96.6% (n: 683), y 487 participantes (71.3%) informaron al menos un ESAVI. Los ESAVI totales fueron 1434 y la incidencia fue 6.3 por 1000 personas/hora. Fueron informadas 469 reacciones locales: 57% de los participantes informaron dolor en el lugar de la inyección y 11% enrojecimiento e hinchazón. Entre las 968 reacciones sistémicas, el 58% de los participantes informaron dolor muscular nuevo o empeorado, 40% fiebre y 5% diarrea. El 5% (n: 34) presentó eventos adversos graves y un paciente tuvo que ser hospitalizado. La tasa de ESAVI fue mayor entre las mujeres (66.4% versus 51.4%; HR 1.38; IC 95% 1.13-5.38) y en el grupo de trabajadores menores de 55 años (63.0 versus 28.0; HR 2.66; IC 95% 1.32-5.38). Este estudio mostró altas tasas de reacciones tempranas locales y sistémicas; sin embargo, los eventos graves fueron raros. Son necesarios estudios sobre la seguridad a largo plazo, estratificados por sexo y edad.

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Abstract This study describes the incidence of early events supposedly attributable to vaccination or immunization (ESAVI) that occurred in healthcare workers who had been inoculated with the first component of the Sputnik V vaccine. Safety at 72 h post-immunization was analyzed based on a self-reported form. Between January 5 and January 20, 2021, in Buenos Aires, Argentina, a total of 707 healthcare workers (median age 35 yrs, female 67%) were vaccinated. The response rate was 96.6% (n: 683) and 487 (71.3%) participants reported at least one ESAVI. The incidence rate was 6.3 per 1000 person/hours. The total number of ESAVIs was 1434. A total of 469 local reactions were reported, 57% of the participants reported pain at the injection site, and 11% had redness and swelling. A total of 968 systemic reactions were informed, including new or worsened muscle pain, referred by 58% of the participants, fever referred by 40%, and diarrhea referred by 5%. Five percent (n: 34) had serious adverse events and one participant had to be hospitalized. The ESAVI rate was higher in females than males (66.4% versus 51.4%; HR 1.38; 95% CI 1.13-5.38) and in workers younger than 55 yrs old (63.0% versus 28.0%; HR 2.66; 95% CI 1.32-5.38). This study demonstrates high rates of early local and systemic reactions. However, serious events were rare. Studies on long-term safety, stratified by sex and age, are needed.

Resumen Este estudio describe la incidencia de eventos supuestamente atribuibles a vacunación o inmunización (ESAVI) en trabajadores de la salud después de la inmunización con el primer componente de la vacuna Sputnik V. La seguridad a las 72 horas de la inmunización se analizó en base a un auto-reporte. En tre el 5 y el 20 de enero de 2021, en Buenos Aires, Argentina, fueron vacunados 707 trabajadores de la salud (mediana de edad 35 años, 67% mujeres). La tasa de respuesta fue 96.6% (n: 683), y 487 participantes (71.3%) informaron al menos un ESAVI. Los ESAVI totales fueron 1434 y la incidencia fue 6.3 por 1000 personas/hora. Fueron informadas 469 reacciones locales: 57% de los participantes informaron dolor en el lugar de la inyección y 11% enrojecimiento e hinchazón. Entre las 968 reacciones sistémicas, el 58% de los participantes informaron dolor muscular nuevo o empeorado, 40% fiebre y 5% diarrea. El 5% (n: 34) presentó eventos adversos graves y un paciente tuvo que ser hospitalizado. La tasa de ESAVI fue mayor entre las mujeres (66.4% versus 51.4%; HR 1.38; IC 95% 1.13-5.38) y en el grupo de trabajadores menores de 55 años (63.0 versus 28.0; HR 2.66; IC 95% 1.32-5.38). Este estudio mostró altas tasas de reacciones tempranas locales y sistémicas; sin embargo, los eventos graves fueron raros. Son necesarios estudios sobre la seguridad a largo plazo, estratificados por sexo y edad.

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RESUMEN Introducción: el Virus de Inmunodeficiencia Humana cada día toma mayor cantidad de vidas en el mundo y en cuba, a pesar de los estudios realizados se estima un gran aumento de esta enfermedad sin que se logre una realidad distinta para la humanidad. Objetivo: disminuir la incidencia de nuevas infecciones mediante la introducción de una estrategia para fomentar conductas orientadoras en la prevención de salud. Método: se realizó una investigación de desarrollo, descriptiva que culminó con el diseño de un instrumento y taller para la capacitación de los equipos básicos de salud en el Policlínico Bayamo Oeste. Resultados: se diseñó un Taller para los equipos Básicos de Trabajos del Policlínico Bayamo Oeste, con cinco temas fundamentalmente encaminados al trabajo del médico y la enfermera de la familia tales como: reglamentos y resoluciones de la educación de posgrado en Cuba; Programa del médico y la enfermera de la familia; generalidades del programa de VIH/SIDA en Cuba y estrategias de la provincia Granma; formación de promotores y atención integral a las personas con VIH/SIDA. Conclusiones: se concluyó con el taller para los equipos básicos de salud como forma organizativa de la superación profesional, según criterios de expertos, contribuyendo un papel fundamental en la preparación de los profesionales en este tema.

ABSTRACT Introduction: the Human Immunodeficiency Virus takes more and more lives in the world and in cuba, despite studies carried out it is estimated a great increase of this disease without a different reality for humanity. Objective: to reduce the incidence of new infections by introducing a strategy to promote guiding behaviors in health prevention. Method: development research was conducted, descriptive that culminated in the design of an instrument and workshop for the training of basic health equipment in the West Bayamo Polyclinic. Results: a Workshop was designed for the Basic Work Teams of the Bayamo West Polyclinic, with five topics mainly aimed at the work of the doctor and nurse of the family such as: regulations and resolutions of graduate education in Cuba; Family Doctor and Nurse Program; generalities of the HIV/AIDS programme in Cuba and strategies of Granma province; promoter training and comprehensive care for people with HIV/AIDS. Conclusions: the workshop for basic health teams was concluded as an organizational form of professional improvement, according to expert criteria, contributing a key role in the preparation of professionals in this topic.

RESUMO Introdução: o Vírus da Imunodeficiência Humana tira cada vez mais vidas no mundo e em Cuba, apesar dos estudos realizados, estima-se um grande aumento dessa doença sem uma realidade diferente para a humanidade. Objetivo: reduzir a incidência de novas infecções, introduzindo uma estratégia para promover comportamentos orientadores na prevenção da saúde. Método: foi realizada pesquisa de desenvolvimento, descritiva que culminou na concepção de instrumento e oficina de formação de equipamentos básicos de saúde na Policlínica de West Bayamo. Resultados: uma Oficina foi projetada para as Equipes de Trabalho Básico da Policlínica Oeste bayamo, com cinco temas voltados principalmente para o trabalho do médico e enfermeiro da família, tais como: regulamentos e resoluções de pós-graduação em Cuba; Programa médico de família e enfermeiro; generalidades do programa HIV/AIDS em Cuba e estratégias da província de Granma; formação de promotores e cuidados abrangentes para pessoas com HIV/AIDS. Conclusões: o workshop para equipes básicas de saúde foi concluído como uma forma organizacional de aperfeiçoamento profissional, segundo critérios de especialistas, contribuindo com um papel fundamental na preparação dos profissionais neste tema.

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RESUMEN El riesgo reproductivo está condicionado por una serie de factores, enfermedades o circunstancias únicas o asociadas que pueden repercutir desfavorablemente en el binomio, durante el embarazo, parto o puerperio. Se realizó un estudio observacional, longitudinal y retrospectivo; con el objetivo de identificar los factores de riesgo preconcepcional en mujeres del Consultorio Médico de Familia 24, perteneciente al Policlínico René Vallejo Ortiz,de Bayamo, entre enero y diciembre del 2017. Se diseñó un estudio de casos y controles no pareados con relación no enfermo-enfermo (4:1), la muestra estuvo conformada por 128 mujeres sanas y 32 enfermas; los datos se obtuvieron a partir de una planilla de recolección de datos aplicada y su historia clínica. Se aplicó como instrumento epidemiológico para tener una medida que cuantifique las fuerzas de asociación, la razón de productos cruzados y el Chi cuadrado. La edad menor de 18 años, mayor de 35 años y la talla inferior a 150 cm se constituyeron en los antecedentes biológicos asociados con el riesgo preconcepcional. El aborto a repetición fue el antecedente obstétrico asociados con este riesgo. Las afecciones asociadas con el mismo fueron la hipertensión arterial, las cardiopatías y el asma bronquial. El bajo nivel de escolaridad fue el antecedente socio ambiental asociado.

ABSTRACT Reproductive risk is conditioned by a series of unique or associated factors, diseases or circumstances that may have an unfavorable impact on the binomial, during pregnancy, childbirth or the puerperium. An observational, longitudinal and retrospective study was carried out; with the objective of identifying the preconceptional risk factors in women of the Family Medical Office 24, belonging to the René Vallejo Ortiz Polyclinic, from Bayamo, between January and December 2017. A study of unmatched cases and controls with a non-ill relationship was designed. - ill (4: 1), the sample consisted of 128 healthy and 32 sick women; the data were obtained from an applied data collection form and its medical history. It was applied as an epidemiological instrument to have a measure that quantifies the forces of association, the ratio of cross products and Chi square. The age under 18, over 35 years and the size below 150 cm were the biological background associated with the preconception risk. Repeated abortion was the obstetric history associated with this risk. The conditions associated with it were high blood pressure, heart disease and bronchial asthma. The low level of schooling was the associated socio-environmental background.

RESUMO O risco reprodutivo é condicionado por uma série de fatores, doenças ou circunstâncias únicas ou associadas que podem ter um impacto desfavorável no binômio, durante a gravidez, o parto ou o puerpério. Foi realizado um estudo observacional, longitudinal e retrospectivo; com o objetivo de identificar os fatores de risco de preconceito em mulheres do Serviço Médico da Família 24, pertencentes à Policlínica René Vallejo Ortiz, de Bayamo, entre janeiro e dezembro de 2017. Foi realizado um estudo de casos e controles incomparáveis ​​com relação não-doente. - doente (4: 1), a amostra foi composta por 128 mulheres saudáveis ​​e 32 doentes; os dados foram obtidos de um formulário de coleta de dados aplicado e seu histórico médico. Foi aplicado como instrumento epidemiológico a medida que quantifica as forças de associação, a proporção de produtos cruzados e o quadrado do Chi. Idade abaixo de 18 anos, acima de 35 anos e tamanho abaixo de 150 cm foram os antecedentes biológicos associados ao risco de preconceito. O aborto repetido foi a história obstétrica associada a esse risco. As condições associadas a ela foram pressão alta, doenças cardíacas e asma brônquica. O baixo nível de escolaridade foi o background socioambiental associado.

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RESUMEN El SIDA es una enfermedad que presenta un comportamiento cada día más elevado a nivel mundial y en nuestro país. Destacándose un mayor aumento en las edades entre 15- 59 años de edad y el sexo masculino. Se realizó un estudio retrospectivo, de corte longitudinal y descriptivo con el objetivo de caracterizar el comportamiento epidemiológico del VIH/SIDA en los diferentes consejos populares del municipio Bayamo, durante el período del año 2018. Se obtuvo un total de 74 casos con TI: 309.7X 106hab donde predominó el Policlínico Bayamo Oeste como el área de salud más afectada con (21) casos: TI 476.4X106hab.; el sexo masculino con (50) casos para una tasa de 428X106hab.; el grupo etario de entre (20-24años) con (13) casos: TI 742.9X106hab.; además del consejo popular del Dátil con (4) casos con una elevada cifra para una tasa de 1326,6X106hab. La incidencia de VIH/SIDA en el municipio Bayamo ha ascendido en los últimos años y el consejo popular de mayor tasa resulta ser el del Dátil con una tasa de 1326,6X106hab.

ABSTRACT AIDS is a disease that presents an increasingly high behavior worldwide and in our country. Highlighting a greater increase in the ages between 15-59 years of age and the male sex. A retrospective, longitudinal and descriptive study was carried out with the objective of characterizing the epidemiological behavior of HIV / AIDS in the different popular councils of the Bayamo municipality, during the period of the year 2018. A total of 74 cases with IT were obtained: 309.7 X 106hab. where the Bayamo Oeste Polyclinic prevailed as the most affected health area with (21) cases: TI 476.4X106hab.; the male sex with (50) cases for a rate of 428X106hab.; the age group between (20-24years) with (13) cases: TI 742.9X106hab.; in addition to the popular council of the Date with (4) cases with a high number for a rate of 1326.6X106hab. The incidence of HIV / AIDS in the Bayamo municipality has risen in recent years and the highest-rate popular council turns out to be that of the Date with a rate of 1326.6X106hab.

RESUMO A AIDS é uma doença que apresenta um comportamento cada vez mais alto em todo o mundo e em nosso país. Destacando um aumento maior nas idades entre 15 e 59 anos e no sexo masculino. Foi realizado um estudo retrospectivo, longitudinal e descritivo, com o objetivo de caracterizar o comportamento epidemiológico do HIV / AIDS nos diferentes conselhos populares do município de Bayamo, durante o período do ano de 2018. Foram obtidos 74 casos com TI: 309,7 X 106hab. onde a Policlínica Bayamo Oeste prevaleceu como a área de saúde mais afetada com (21) casos: TI 476.4X106hab.; o sexo masculino com (50) casos por uma taxa de 428X106hab.; a faixa etária entre (20-24 anos) com (13) casos: TI 742.9X106hab.; além do conselho popular da Data com (4) casos com um número alto por uma taxa de 1326,6X106hab. A incidência de HIV / AIDS no município de Bayamo aumentou nos últimos anos e o conselho popular de maior taxa é o da Data, com uma taxa de 1326,6X106hab.

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We report the case of a 47-year-old male patient with S100 negative granular cell tumor of the oral cavity, focusing on dermoscopic features as well as surgical approach, not previously reported in the literature. The study contributes to the literature on dermoscopy and surgical treatment for this tumor and provides a practical approach to differentiating non-neural granular cell tumors and granular cell tumors.

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Abstract: We report the case of a 47-year-old male patient with S100 negative granular cell tumor of the oral cavity, focusing on dermoscopic features as well as surgical approach, not previously reported in the literature. The study contributes to the literature on dermoscopy and surgical treatment for this tumor and provides a practical approach to differentiating non-neural granular cell tumors and granular cell tumors.

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Diabetes Mellitus (DM) and obesity are a public health problem in Chile. Bariatric surgery is the most effective treatment alternative to achieve a significant and sustained weight reduction in patients with morbid obesity. The results of controlled clinical trials indicate that, compared to medical treatment, surgery for obese patients with DM2 allows a better control of blood glucose and cardiovascular risk factors, reduces the need for medications and increases the likelihood for remission. Consensus conferences and clinical practice guidelines support bariatric surgery as an option to treat DM2 in Class III Obesity (Body Mass Index (BMI) > 40) regardless of the glycemic control and the complexity of pharmacological treatment and in Class II Obesity (BMI 35-39,9) with inadequate glycemic control despite optimal pharmacological treatment and lifestyle. However, surgical indication for patients with DM2 and BMI between 30-34.9, the most prevalent sub-group, is only suggested. The Chilean Societies of Endocrinology and Diabetes and of Bariatric and Metabolic Surgery decided to generate a consensus regarding the importance of other factors related to DM2 that would allow a better selection of candidates for surgery, particularly when weight does not constitute an indication. Considering the national reality, we also need a statement regarding the selection and characteristics of the surgical procedure as well as the role of the diabetologist in the multidisciplinary team.

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Se realizó un estudio analítico, observacional, de casos y controles, en niños de los círculos infantiles Pétalos de Rosa y La Espiguita, pertenecientes al área de salud del Policlínico Docente Armando García Aspurú de Santiago de Cuba, durante el período de febrero de 2015 a marzo de 2016, con vistas a determinar los factores maternos y neonatales asociados al retraso en la aparición de dientes temporales. La población quedó conformada por 150 niños de 2do a 4to años de vida, de los cuales se tomaron 2 controles (N=100) por cada caso (N=50). En la serie se obtuvo asociación estadísticamente significativa de las variables estado nutricional de la madre, ganancia de peso de la madre, enfermedades maternas, lactancia materna y peso del niño al nacer, con la alteración del brote dentario temporal en los niños. Se recomendó realizar intervenciones educativas en los círculos infantiles y las comunidades para apoyar el trabajo del médico de la familia

An analytic, observational, of cases and controls study, in children from Pétalos de Rosa and La Espiguita day care centers, belonging to the health area of Armando García Aspurú Teaching Polyclinic was carried out in Santiago de Cuba, during February, 2015 to March, 2016, aimed at determining the maternal and neonatal factors associated with the delay in the emergence of the temporary teeth. The population was conformed by 150 children from 2nd to 4th years of life, from whom 2 controls were taken (N=100) for each case (N=50). In the series a statistically significant association of the variables mother's nutritional state, mother's weight gain, maternal diseases, breast feeding and child birth weight was obtained, with the disorder of the temporary teething eruption in the children. It was suggested to carry out educational interventions in the day care centers and communities to support the family doctor's work

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RESUMEN Las máscaras laríngeas son dispositivos supraglóticos que ofrecen una alternativa a la tradicional intubación endotraqueal con potenciales beneficios. El propósito de este trabajo fue mostrar el estado actual de las máscaras laríngeas en Anestesiología y Reanimación. Se realizó una búsqueda sobre el tema en documentos impresos y electrónicos, así como en las siguientes bases de datos: Registro Cochrane Central, Lilacs, PubMed/Medline, SCielo regional, Google. En estos momentos existe una amplia gama de mascarillas laríngeas cuyo diseños superan a las anteriores en cuanto a facilidad y tiempo de inserción, presión de sellado y menor riesgo de complicaciones; lo que ha permitido incrementar su uso en pacientes pediátricos, obesos, obstétricas, en cirugía laparoscópica, en el algoritmo de la vía aérea difícil, en la reanimación cardiopulmonar, fuera del quirófano y en el medio extrahospitalario (AU).

ABSTRACT Laryngeal masks are supraglottal devices offering an alternative to the traditional endotracheal intubation with potential benefits. The purpose of this work was showing the current status of the laryngeal masks in Anesthesiology and Reanimation. A search on the theme was carried out in electronic and printed documents, and also in the following databases Central Cochrane Register, Lilacs, PubMed/Medline, SCielo regional and Google. At this moment there is a wide variety of laryngeal masks, the design of which excels the previous one in parameters like insertion easiness and time, sealing pressure and less risks of complication, allowing increasing their use in pediatric, obese and obstetric patients, in laparoscopic surgery, in the algorithm for the difficult airway, in cardiopulmonary reanimation, outside the operating room and in extra hospital settings (AU).

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Diabetes Mellitus (DM) and obesity are a public health problem in Chile. Bariatric surgery is the most effective treatment alternative to achieve a significant and sustained weight reduction in patients with morbid obesity. The results of controlled clinical trials indicate that, compared to medical treatment, surgery for obese patients with DM2 allows a better control of blood glucose and cardiovascular risk factors, reduces the need for medications and increases the likelihood for remission. Consensus conferences and clinical practice guidelines support bariatric surgery as an option to treat DM2 in Class III Obesity (Body Mass Index (BMI) > 40) regardless of the glycemic control and the complexity of pharmacological treatment and in Class II Obesity (BMI 35-39,9) with inadequate glycemic control despite optimal pharmacological treatment and lifestyle. However, surgical indication for patients with DM2 and BMI between 30-34.9, the most prevalent sub-group, is only suggested. The Chilean Societies of Endocrinology and Diabetes and of Bariatric and Metabolic Surgery decided to generate a consensus regarding the importance of other factors related to DM2 that would allow a better selection of candidates for surgery, particularly when weight does not constitute an indication. Considering the national reality, we also need a statement regarding the selection and characteristics of the surgical procedure as well as the role of the diabetologist in the multidisciplinary team.

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En busca de novedosos enfoques metodológicos para la resolución de problemas, el objetivo de este trabajo consistió en mostrar los resultados de la labor interdisciplinaria del profesorado de Microbiología y Parasitología médicas en ese sentido, basada en la creación de los siguientes materiales didácticos: Manual de respuesta inmune a los agentes biológicos para estudiantes de medicina, Sistema de habilidades para el perfeccionamiento de la asignatura y Guía didáctica de los agentes biológicos que agreden al ser humano, entre otros. El claustro de profesores estableció una nueva relación entre estudiante y docente, derivada de profundos cambios en el método de enseñanza para cumplir la exigencia interdisciplinaria en la formación académica de los educandos y contribuir a la integración de la asignatura.

Searching novel methodological approaches for the solution of problems, the objective of this work consisted on showing the results of the interdisciplinary work of the professors staff in medical Microbiology and Parasitology in that sense, based on the creation of the following didactic materials: Manual of immune response to the biological agents for medicine students, Skill system for the improvement of the subject and Didactic Guide of biological agents which attack the human being, among others. The board of professors established a new relation between students and teaching staff, derived from deep changes in the teaching method to complete the interdisciplinary demand in the academic training of students and to contribute to the integration of the subject.

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A pesar de los avances en tratamiento del traumatismo craneoencefálico, este continúa cobrando vidas y en otros casos dejando secuelas permanentes que no permiten la integración del individuo a la sociedad, ocasionan una situación psicológica inaceptable para el paciente y la familia, que en muchas ocasiones debe apartarse de su trabajo, lo que provoca una carga económica adicional que aunada a la enfermedad hacen la vida familiar extremadamente difícil. Se realizó una revisión bibliográfica con el objetivo de actualizar la conducta inicial en los pacientes con traumatismo craneoencefálico grave para prevenir las lesiones secundarias. Para ello, se llevó a cabo una revisión el tema en libros, documentos impresos y en línea, a partir de una búsqueda en las siguientes bases de datos: Pubmed, Registro Cochrane Central, Bireme, Ebsco, Mediclatina y Lilacs. Se seleccionaron los artículos científicos de forma que el total de ellos cumplieran con los siguientes criterios: el 70 % correspondientes a los últimos cinco años y de estos el 75 % a los últimos tres años. Se concluye que el tratamiento en la fase prehospitalaria es determinante para la evolución de los pacientes con traumatismo craneoencefálico grave, por tal motivo es necesaria una intervención rápida y adecuada para prevenir las lesiones secundarias.

Although there have been advances in cranioencephalic treatment, it still continues covering lives and in other cases leaving permanent sequels not allowing the integration to society, leading to a psychological situation that patients and his/her relatives could not agree to; in cases they should leave their job causing an additional economical charge that joined to disease make the family life extremely difficult. We carried out a bibliographic review with the objective of updating the initial behavior in patients with serious cranioencephalic trauma to prevent secondary lesions. For that we reviewed the theme in books, printed and online documents searching for in the following databases: Pubmed, central Cochrane register. Bireme. Ebsco, Mediclatina and Lilacs. We chose the scientifc articles in such a way that all of them would fulfill the following criteria: 70 % published in the last five years, and 75 % of them during the last three years. We arrived to the conclusion that pre-hospital stage treatment is determinant for the evolution of patients with serious cranioencephalic trauma; for that reason it is necessary a fast and adequate intervention to prevent secondary lesions.